Archive for Health

Health insurance premiums continue to rise. Hassles abound for patients and physicians alike. Tens of millions of Americans are uninsured. And these problems are only expected to worsen in coming years. The system is flawed, to be sure. But isn’t the main problem with U.S. healthcare the fact that it’s simply overburdened?

People are sick and getting sicker. In particular, rates of heart disease, Western cancers, type 2 diabetes, multiple sclerosis and osteoperosis only seem to keep climbing.

So many doctors these days are treating symptoms rather than causes. Health care reform, to a large extent, seems to be taking the same approach — ignoring the real underlying problem.

Perhaps the most interesting aspect of health care is the role of the patient, and the average patient in the U.S. today is making themselves sick by putting garbage into their body, meal after meal, day after day. Issues of personal responsibility aside, overly processed crap is killing us and costing us a fortune in the process.

The food industry peddles addictivesubstances for enormous profits, then the health care industry strings along its “patients” (read: customers) with a pill for every ill.

Remember that adage you heard a million times growing up? “You are what you eat.” It was overused for a reason: because it’s true.

Remember that other one? “An apple a day keeps the doctor away”? While it’s a gross simplification, it holds a profound economic truth: They are substitute products for one another.

So here’s the question: Where is the money in educating people, making them healthy and getting them out of “the system”? How do you incentivize health care professionals to steer patients (or potential patients) toward their own substitutes?

It seems impossible, doesn’t it? This appears to be one of those situations where regulatory policy would be a fantastic boon for the public interest — if we could reach some semblance of agreement on what the actual problem is.

Unfortunately, there are wildly varying viewpoints on what is “healthy,” and the science often flies in the face of conventional wisdom. For example, existing educational efforts, such as MyPlate (the new food pyramid), recommend a diet rich in dairy products, which most independent research suggests can be quite harmful. Meanwhile, much of the so-called science is tainted by corporate interests and many of the researchers are guided by personal biases, so it’s difficult to know what to trust.

At the same time, food marketing “facts” and even government regulated nutrition labels are notoriously deceptive. For instance, the label on the front of a can of soup might say it is “98 percent fat free,” but when you turn it around you find that the nutrition label shows it derives 70 percent of its calories from fat. (The FDA and USDA allow companies to calculate fat by weight rather than by calories for front-of-package claims.) The classic example is Pam cooking spray, which says on the front of the can, “Fat Free.” But think about it: What is Pam made out of? Oil, which is 100 percent fat. Dietician and nutritionist Jeff Novick has a brilliant routine about how they get away with this. (It’s definitely worth a watch.)

The water is further muddied by an increasing number of Americans who equate weight loss with health (while they often go hand-in-hand, one does not necessarily imply the other). Long story short, it’s an incredibly complex issue, but one that has extremely far-reaching implications for not only our economic and ecological sustainability, but for the very future of our species.

It’s quite a tangled mess, but if we don’t start teasing it out soon it will only get worse. One way or the other, government probably has a role in that. Obviously I’m not advocating government regulation of what you’re allowed to put in your mouth. I absolutely believe in personal responsibility, but I also happen to think it’s wrong that a company can sell you shit and use taxpayer funded programs to tell you it’s shinola.

Policy doesn’t just fall from the sky. It exists for a reason. Anyone who’s really curious what the “invisible hand” of a completely unfettered market would feed us can get a glimpse of that disturbing reality (and the conditions that led to the establishment of the FDA) by reading Upton Sinclair’s muckraking classic, “The Jungle.” It was written over a hundred years ago, but it couldn’t be more relevant if it was penned just yesterday.

Now pardon me while I get off my soapbox and get back to this 32-oz. cup of Mr. Pibb.

If you’re a man who happens to be age 40 or over and you experience chest pains, do not dilly-dally, they say. Go immediately to the Emergency Room. This is not a drill; this is the real thing.

Health care industry workers take this particular symptom so seriously, in fact, that one time years ago, well before I was 40, I called my Primary Care Physician about a digestive issue and as soon as I mentioned feeling something — anything — in my chest, the nurse urged me to hang up and dial 911.

I’ve suffered from dyspepsia, reflux and a host of related upper-gastrointestinal issues my entire adult life, and as a result I’m intimately familiar with what it feels like to have simple, or even severe, indigestion.

So in May when I felt some discomfort in my chest that was unlike anything I’d experienced before, I panicked a bit. I’m not overweight, I don’t have high blood pressure and I have no real family history of cardiac disease, but I don’t live the healthiest lifestyle, either, and I’ve been a cigarette smoker for the better part of 17 years.

With that in mind, along with my age (40), I decided I should heed conventional wisdom. As it says in one of the medical books I pore over frequently (because, let’s be honest, I’m a bit of a hypochondriac), “Any adult who suddenly experiences discomfort in the chest must assume that it has something to do with the heart and act accordingly.” So off I went.

I drove up to the ER, walked inside, approached the check-in window and began explaining my situation to the woman behind the counter. Now, I work in a newsroom where we’ve grown jaded and unimpressed by ordinary events, such as murder, violence and corruption, so it’s only when something truly remarkable happens — say, a gunman is holding a hostage in the local elementary school parking lot, or a tanker explodes on the freeway killing two police officers — that we really even bother to wake up. In those rare electric moments, you can literally see a palpable energy spreading across the room like “The Wave” at a football game. When I uttered the words “chest pain” at the ER check-in window, I felt the spark of that same energy and watched as it flashed across their faces and shot through their limbs. Suddenly the room was all abuzz, and its meaning was clear: “Holy shit, we’ve got ourselves a bonafide emergency!”

I was fast-tracked to the ER. “We can fill out your paperwork later,” said the nurse who escorted me urgently to my bed. Without delay, another nurse hurriedly began hooking me up to everything in sight. Electrodes were attached to my chest and an IV was jabbed into my arm. My heart rate and blood pressure were checked. Blood was drawn. A chest X-ray was taken. An electrocardiogram was performed. My condition was stable.

Thirty minutes later, a doctor shuffled in. “You’re fine,” he said. He suggested it was indigestion. I respectfully disagreed. He recommended an endoscopy. I took it under advisement. He sent me on my way.

And that, more or less, was that. I trusted conventional wisdom. I consulted a doctor. I explained my symptoms and I was whisked away into a whirlwind of health care procedures that, presumably, were in my best interest. And then I was given a clean bill of health, or at least a reasonably clean one, and dismissed. “Nothing to worry about,” was the verdict. Who was I to argue? The doctor knows best.

Sure enough, within a few hours, the weird pressure in my chest was completely gone. “I guess I’m fine, after all,” I thought. “Awesome!”

And it was. Except …

Two weeks later the bills started showing up. Bills. Plural.

I got one from the hospital itself for $623. I got another one from the doctor I saw for $89.54. I got a third from my Primary Care Physician for $25. I got a fourth from another doctor for $27.64. Total cost out of my pocket: $765.18.

The kicker? None of them — not one — really explains exactly what it’s for. “Services rendered,” one says. By comparison, another that reads “Emergency visit” is acutely specific. Other charges listed on my various bills include “Drugs,” “Laboratory” and “Emergency Room.”

Now, I’m the first person to admit that I don’t know shit about how health insurance works. But this seems unnecessarily convoluted and (intentionally?) inscrutable.

I was there for less than an hour. I saw two nurses and spoke to one doctor. I did as I was told. I trusted them.

I have health insurance through my employer, and from what people who know about this stuff have told me, my coverage is pretty good. I realize a trip to the ER isn’t exactly “preventative” care, but considering the circumstances I’d think this would be something that would be fully (or, at least, mostly) covered.

Each year, I pay over $1,000 before taxes out of my paycheck and my employer graciously contributes something like three times that amount. In exchange for that, I get “coverage.”

What does “coverage” mean? I don’t have the slightest idea. But what it appears to mean is that my employer and I make a substantial “loan” to an insurance company, and then if I get sick they go ahead and put that money toward the parts of my bills that they find agreeable and then charge me for the rest. But if I don’t get sick — or sick enough, anyway — they simply pocket the change.

I’m sure it’s more complicated than that. I’m certain of it. What I don’t understand is why.

Why am I paying money to doctors I never saw? Why am I getting four different bills for one ER visit? Why are there 19 different nebulously designated items on my various bills? And how much of these unexplained costs are the result of nothing more than the fact that we’ve created a system that is needlessly complex?

I don’t have any answers for any of that. Like I said, I’m clueless about this stuff.

But here’s one thing I know: Given my current financial situation, if I experience severe chest pains tomorrow, I hope it’s no big deal because I’m not going to the ER. I don’t trust the system anymore. I don’t trust conventional wisdom.

The same book I referenced above goes on to say, “If it turns out to be a false alarm, you’ve lost nothing. But if it indeed was the heart, you may have saved your life!”

True enough on that last count.

But the first part? Not so much.

Copyright 2012 by Rommie Johnson. This work is licensed under a Creative Commons Attribution-Noncommercial-No Derivative Works 3.0 License.